Individual provider Active NPI

Laci Ann Banker, CNM

  • Advanced Practice Midwife
  • Richland Center, WI
National Provider Identifier
1861022279
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
333 E 2ND St
Richland Center, WI 53581-1914
Phone
(608) 647-6321
NPI assigned
Jan 24, 2020
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X WI Primary

Addresses

Primary practice location

333 E 2ND St
Richland Center, WI 53581-1914

Mailing address

22995 State Hwy 60
Muscoda, WI 53573-5592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200324001847 WI Practitioner - Certified Nurse Midwife (CNM) 4486082567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland HospitalGroup PAC ID 7618861618, 69 clinicians

Practice addresses (Care Compare)

333 E 2ND St
Richland Center, WI 53581-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Hospital CurrentSince Mar 1, 2020 Accepting new patients
Richland Hospital CurrentSince Mar 1, 2020 Accepting new patients
Richland Hospital Past Accepting new patients

Locations

1075 N Wisconsin Ave
Muscoda, WI 53573
Phone (608) 739-3113

301 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1861022279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22995 STATE HWY 60",
            "city": "MUSCODA",
            "state": "WI",
            "postal_code": "535735592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811914",
            "telephone_number": "608-647-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKER",
        "first_name": "LACI",
        "middle_name": "ANN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland Center, WI

Sources for this page

Verify at the official NPI Registry.